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What Makes Someone Worthy of Help?

July 21, 2015

By Kelly Davis, MHA Policy and Programming Associate

After reading this Washington Post article about Alfred Postell, the Harvard Law graduate experiencing homelessness and diagnosed with schizophrenia, I was overwhelmed with frustration. While this man is important and deserves access to services, the story brings up important questions to ask in our mainstream discussion of mental health. The glaring stereotypes and what the article says about how we view certain populations in our society are worth discussing.

It appears that people are shocked specifically because this man is educated, but mental health disorders are prevalent throughout all groups in our society. While there are social determinants that no doubt increase an individual’s vulnerability that need to be addressed on a systemic level, receiving an education, even one from an esteemed school like Harvard, does not protect you from developing symptoms of mental health disorders. The opposite is true as well. Having a mental health disorder does not make you unintelligent or unable to achieve academic success.

Another point worth noting is what is not said in this article. A publication by the Metropolitan Washington Council of Governments indicated that as of January 2015, 11,623 people in the District of Columbia identified as experiencing homelessness. We know that a disproportionately large percent of the homeless population is exposed to trauma and has a diagnosable mental health disorder. Why are we not as outraged about the experiences of each of these individuals? What makes someone worthy of help or interest?

When issues on mental health and social justice are brought into the mainstream, it is important to be critical of how we discuss them. While I appreciate that the Washington Post article is highlighting the troubles faced by one man, I wonder if it reflects misguided stereotypes about what it takes to be deemed worthy of help or interest in our culture. We should provide Alfred Postell with the full spectrum of supports and services he wants and needs, just as we should help all others regardless of education level.

Comments

Where are people's compassion, love, care, concern and commitment? Does in sickness and health not mean any sickness? The critics should beware, it may well happen to you or your loved yet--grandchildren etc. Never say it will never happen to you. Look at the people who thought they were smug in their jobs and at 55 out of work with nothing to live on. MENTAL ILLNESS WASN'T A CHOICE--IT HAPPENS! Who chooses Alzheimer's or cancer.

I am intelligent, high IQ, with a graduate degree in molecular biology. I have severe and complex PTSD because of multiple traumas. I need in-home care. I live in Nebraska, and have been stalemated at every turn for the last 4 years. I cannot leave my home, nor do I function well inside my home due to constant flashbacks. Yet because I am such an articulate and intelligent individual, and also my own best advocate, I keep being told "you don't qualify for services." The benefit management company, Magellan, keeps telling me "there's no reason you don't qualify, go get an assessment, and have the agency submit it." So I go get an assessment, but because I don't have what the state of Nebraska considers an SPMI diagnosis, (and there are only 5 diagnoses the state accepts as severe - yes, only five), the agencies won't even submit the bill, and tell me "sorry, you don't have the right diagnosis to get in-home services."

So for the last 4 years I have been ping pong balled back and forth between the benefit management company and the agencies. I tried to even get admitted as an inpatient, but I was turned away, because unless you are suicidal or a danger to others, Nebraska won't allow inpatient services. So, I remain in my home with no help, and no access to help.

I found a study on this website that stated Nebraska was in the top 3 states for recidivism, and that the numbers of mentally ill clients are low. I laugh at this study, because as a scientist I will state that it did not accurately measure what it hoped to measure. You state that Nebraska has a low number of mentally ill clients, but that is specious at best. I will tell you why Nebraska came out as having a low mentally ill population...it is because Nebraska will only consider the minute few as mentally ill.

You also state that Nebraska's mentally ill don't return back, so you assessed that the state's recidivism rate is also low. Wrong again, as the mentally ill don't go back for services, because the hospitals won't allow them back unless their situation has plummeted to such an extreme they are now a danger to themselves or others. This study went from researching "A" to concluding "Z," but skipped "B" though "Y." And "B" through "Y" are all the confounding variables you didn't assess, which are the real reasons for finding "Z."

What you failed to ascertain in this study were the REASONS why people don't go back, and the REASONS why Nebraska appears to have such a low mentally ill population. Why they don't go back certainly isn't because they got well, or because Nebraska has some great mental health system. Nope...it's because Nebraska refuses them, and won't diagnose them as mentally ill. Nebraska stalemates the mentally ill, and sooner or later, they just get tired of trying.

Point blank, your study measured nothing. Nebraska needs to either change its benefit management company, or educate their facilities on what mental illness actually is, and that there are more than just FIVE diagnoses that can be considered as SPMI.

That study really made worse the already dim situation of the mentally ill in Nebraska, as it was a false positive, and now it will be even harder for the mentally ill in Nebraska to be diagnosed. Nebraska is flying high with arrogance now, when they really should be ashamed of themselves.